Multigene Methylation Analysis And The Noninvasive Diagnosis Of Prostate Cancer From Body Fluids

Introduction During prostatic carcinogenesis, DNA hypermethylation occurs, thus representing a promising biomarker for the early detection of this malignancy. In our study, we aim to determine the usefulness of a molecular and multigene test for prostate cancer. However, this is based on the quantitative methylation-specific polymerase chain reaction (qMSP) of three genes from voided urine specimens by noninvasive methods. Materials and Methods In this study, the voided urine specimens were collected from 89 patients with prostate cancer and 69 controls. Genomic DNA was isolated and subjected to bisulfite modification. Consequently, we tested the methylation status of genomic DNA of three genes, namely: GSTP1, APC, and MDR1. This was done using the quantitative methylationspecific PCR method. Therefore, the obtained results were correlated with the clinicopathologic findings. Results Promoter methylation of GSTP1 gene in voided urine samples was found in 87 out of 89 (97.8%) PCa patients and in 13 out of 62 (21 %) BPH men. In APC gene, methylated levels have been found in 61 out of 89 (68.5%) PCa patients and in 8 out of 62 (12.9%) BPH men. MDR1 gene was found to be hypermethylated in 60 out of 89 (67.4%) PCa patients and in 4 out of 62 (6.5%) BPH men. In addition, we obtained a sensitivity of 88.99% and a specificity of 85.5% for the multigene panel. The AUC in this case was 0.927. Conclusion The analysis of a multigene panel of three methylated genes in prostate cancer by qMSP, can be used to distinguish between men with malignant and benign prostatic diseases from voided urine specimens. Also, it can be used for the follow-up of those men who are presenting increased risk of prostate cancer by noninvasive methods

PERIPHERAL BLOOD CELL DNA METHYLATION AND HYDROXYMETHYLATION IN PROSTATE CANCER. A PILOT STUDY

Objective/Purpose: DNA methylation is an important epigenetic hallmark of cancer, including prostate cancer, with a general pattern of global hypomethylation accompanied by hypermethylation at certain gene promoters’ level in tissues. Limited evidence exists on the methylation pattern of blood cells in prostate cancer patients, which this pilot study is addressing. Material and Methods: DNA methylation and hydroxymethylation levels were assessed in peripheral nucleated blood cells from prostate cancer patients compared to controls using fluorimetric ELISA-type assays that directly measure the amount of 5mC and 5hmC, respectively. Results: There was significant difference in global DNA methylation levels between prostate cancer patients and controls, with almost two-fold hypomethylation observed in patients’ blood cell DNA (p<0.0001). There was no statistical significant difference regarding the hydroxymethylation levels. Conclusions: In this pilot study of limited sample sizewe found evidence of different levels of global DNA methylation in blood cells of prostate cancer patients compared to controls. These findings need further replication in future larger studies in order to assess the biomarker potential of blood cells DNA methylation and hydroxymetylation in prostate cancer

Bipolar vaporization of the prostate: is it ready for the primetime?

Although transurethral resection of the prostate is still the ‘gold standard’ in the surgical management of benign prostatic hyperplasia, it is associated with significant morbidity. This review presents one of its most successful alternatives, bipolar transurethral vaporization of the prostate, a procedure that has emerged during the last decade. The technical principles are presented, together with the trials that compare it with the standard resection technique. The review concludes that bipolar vaporization of the prostate is safe and effective, providing very good hemostasis control and low complication rates, at a significantly reduced cost per procedure. Improved vision and hemostasis make it suitable for patients with cardiac pacemakers, bleeding disorders, or those under anticoagulant therapy. However, long-term follow-up and more randomized trials are still needed, to validate the value of bipolar vaporization

The Impact of the Dermal Matrix in Tissue Reconstruction: A Bibliometric Perspective in Plastic Surgery

In the vast field of medical scientific research, few topics have managed to attract as much attention and mobilise academic resources as the use of dermal matrices in the reconstruction of soft tissue defects. In this study, we used bibliographic metrics such as co-authorship, keyword co-occurrence, and citations per document to analyse the relationship between the use of dermal matrices to reconstruct soft tissue defects caused by burns, tumours, and trauma. In addition, keyword analysis has highlighted the crucial role of technology in recent studies and the innovation brought about by the use of dermal matrices in the reconstruction of soft tissue defects. Keywords used in recent studies have revealed the critical role of technology in the development of the field. We extracted a set of 1329 research papers from the Web of Science Core Collection database between 2010 and 2024 that met our criteria. Through keyword analysis, we identified technology as a significant factor in recent studies. Our results showed that there is very little collaboration between authors on the topic and that most of them are from Asia. A significant number of articles on this topic come from the USA, China, Japan, Germany, the UK, and France. We discovered the top ten most cited sources analysing the use of dermal matrices in the reconstruction of soft tissue defects. Finally, we think that this study will be beneficial for our further research

Factors influencing recurrent reflux acute pyelonephritis in patients with JJ ureteral stent after discharge

The vesicoureteral reflux (VUR) after the insertion of a JJ stent is a pathological entity characterized by the impossibility of the vesicoureteric junction (VUJ) to exhibit its sphincterian functioning that allows the unidirectional flow of urine from the ureter to the bladder. This happens as long as the catheter is in place, and after its suppression due to traumatization of the ureterovesical junction, which loses its tonicity and ability to ensure urinary unidirectional flow. Reflux acute pyelonephritis is the acute inflammation of the renal tract and parenchyma resulting from stagnation of infected urine for long periods of time due to vesicoureteral reflux. We have noted multiple cases which, after the insertion of a JJ stent, presented reflux acute pyelonephritis due VUR, we considered the causes favoring these aspects. We focused on the frequency of reflux acute pyelonephritis and identified factors that could be used to advise patients with JJ stents

Diagnostic Value of microRNA-375 as Future Biomarker for Prostate Cancer Detection: A Meta-Analysis

Background and Objectives: Responding to the need for additional biomarkers for the diagnosis of prostate cancer (PCa), mounting studies show that microRNAs (miRNAs/miRs) possess great potential as future promising diagnostic tools. However, the usefulness of these miRNAs is still highly debated, as the degree of inconsistency between study designs and results is still elevated. Herein, we present a meta-analysis evaluating the diagnostic value and accuracy of circulating miR-375, as it is one of the most studied types of miRs in PCa. Materials and Methods: The diagnostic accuracy of miR-375 was evaluated using the QUADAS-2 tool, analyzing different statistical parameters. The seven studies (from six articles) that matched our selection included 422 PCa patients and 212 controls (70 healthy volunteers + 142 with benign prostate diseases). Results and Conclusion: We obtained a p-value of 0.76 for sensitivity, 0.83 for specificity, 16 for DOR, 4.6 for LR+, 0.29 for LR−, and 0.87 for AUC (95% CI 0.83–0.89). Our results confirm that miRNA-375 has high diagnostic potential for PCa, suggesting its usefulness as a powerful biomarker. More comprehensive studies are warranted to better assess its true value as a diagnostic biomarker for this urologic disease

Evaluating Established Roles, Future Perspectives and Methodological Heterogeneity for Wilms&rsquo; Tumor 1 (WT1) Antigen Detection in Adult Renal Cell Carcinoma, Using a Novel N-Terminus Targeted Antibody (Clone WT49)

Renal cell carcinoma (RCC) is arguably the deadliest form of genitourinary malignancy and is nowadays viewed as a heterogeneous series of cancers, with the same origin but fundamentally different metabolisms and clinical behaviors. Immunohistochemistry (IHC) is increasingly necessary for RCC subtyping and definitive diagnosis. WT1 is a complex gene involved in carcinogenesis. To address reporting heterogeneity and WT1 IHC standardization, we used a recent N-terminus targeted monoclonal antibody (clone WT49) to evaluate WT1 protein expression in 56 adult RCC (aRCC) cases. This is the largest WT1 IHC investigation focusing exclusively on aRCCs and the first report on clone WT49 staining in aRCCs. We found seven (12.5%) positive cases, all clear cell RCCs, showing exclusively nuclear staining for WT1. We did not disregard cytoplasmic staining in any of the negative cases. Extratumoral fibroblasts, connecting tubules and intratumoral endothelial cells showed the same exclusively nuclear WT1 staining pattern. We reviewed WT1 expression patterns in aRCCs and the possible explanatory underlying metabolomics. For now, WT1 protein expression in aRCCs is insufficiently investigated, with significant discrepancies in the little data reported. Emerging WT1-targeted RCC immunotherapy will require adequate case selection and sustained efforts to standardize the quantification of tumor-associated antigens for aRCC and its many subtypes

Pandemic Stressors and Adaptive Responses: A Longitudinal Analysis of the Quality of Life and Psychosocial Dynamics among Urothelial Cancer Patients

The 2019 coronavirus disease (COVID-19) pandemic has had a profound influence on different sectors of society, including health. This study hypothesized a significant impact of the pandemic on the quality of life and psychosocial well-being of urothelial cancer patients, specifically anticipating a decrease in anxiety and depression scores as the pandemic progressed. The primary objectives were to assess longitudinal changes in quality of life indexes, evaluate Healthcare Anxiety and Depression Scale (HADS) score trends over three years (2020–2022), and identify any correlational patterns between the progression of the pandemic and anxiety, depression, and stress levels among this cohort. A cross-sectional analysis was conducted on Eastern Cooperative Oncology Group (ECOG) 1 and Tumor Node Metastasis (TNM) stage 1 bladder cancer patients from the Timis County Emergency Clinical Hospital in Romania. Sixty patients were evaluated each year from 2020 to 2022, utilizing a detailed selection process involving the review of both the hospital database and paper records. Key data included demographic information, medical history, and responses to the Patient Health Questionnaire (PHQ-9), Short Form (SF-36), HADS, and Generalized Anxiety Disorder (GAD-7) questionnaires. A total of 163 completed questionnaires were analyzed, providing insight into various aspects of patients’ experiences during the pandemic. Notably, the mean hospitalization days ranged from 3.6 ± 2.1 days in 2020 to 4.0 ± 2.4 days in 2022 (p = 0.663). Concerns that current symptoms might be pandemic-related spiked to 63.5% in 2021, but reduced to 50.9% in 2022, with this fluctuation being significant (p = 0.026). The perception of decreased quality of or accessibility to medical care was significant over the years, with a decline to 52.7% in 2022 (p = 0.033). Quality of life assessments demonstrated an upward trend, from an average score of 55.9 ± 8.9 in 2020 to 59.3 ± 8.8 in 2022 (p = 0.049). Interestingly, anxiety levels, as indicated by the HADS survey, revealed a significant decline from a score of 7.8 in 2020 to 6.5 in 2022 (p = 0.008). On the other hand, GAD-7 scores displayed a downward trend over the years, potentially indicative of developed coping strategies (p = 0.034). This study provides a comprehensive insight into the fluctuating dynamics of psychosocial factors and quality of life among urothelial cancer patients during the pandemic years. It underscores a potential adaptive response, as evidenced by the decrease in anxiety levels and an upward trend in the quality of life scores over the period. These findings highlight the resilience and adaptability of this patient cohort amidst the challenges posed by the pandemic, potentially guiding future interventions and supports in similar health crises

The Assessment of SF-36 Survey for Quality-of-Life Measurement after Radical Cystectomy for Muscle-Invasive Bladder Cancer: A Systematic Review

This study presents a systematic review of the literature on individuals’ health-related quality of life (HRQoL) following radical cystectomy for muscle-invasive bladder cancer (MIBC), utilizing the Short Form-36 Health Survey (SF-36) as a primary assessment tool. The review was designed as an exhaustive literature search across three major databases including PubMed, Scopus, and Embase up to December 2023, using the PRISMA guidelines. The selection process refined 2281 identified articles down to 11 studies meeting our inclusion criteria. These studies encompassed a diverse demographic and clinical profile of 774 participants, with follow-up durations ranging from 3 to 130 months, thereby offering insights into both short-term and long-term HRQoL outcomes. The results highlighted significant alterations in individuals’ HRQoL across various domains post-radical cystectomy. Notably, the Physical Functioning (PF) and Bodily Pain (BP) domains generally scored higher, indicating a moderate to high perceived physical health status. However, the Role Physical (RP) and Role Emotional (RE) domains showed variability, reflecting the challenges in daily role fulfillment and emotional adjustment post-surgery. A marked variability in physical recovery was observed, with studies reporting significant differences in PF and RP scores between patient groups. The General Health (GH) and Vitality (VT) domains sometimes reflected perceived deteriorations, whereas the Mental Health (MH) scores suggested that many patients maintained or achieved high levels of well-being post-operatively. The conclusions drawn from this systematic review underscore the profound and multi-faceted impact of radical cystectomy on HRQoL, varying widely between studies, being influenced by geographic factors, surgical methods, and the time of evaluation. The findings emphasize the necessity for holistic patient care approaches that address both physical and emotional rehabilitation, aiming to improve HRQoL outcomes